Tuberculosis Awareness

T. B. Clinic

Brief History of the T.B. Clinic

Started at Chunamandi, Paharganj, in a small rented room in October 1933, “as a philanthropic institution” to serve specially the poorer sections of the community, the clinic was shifted to a comparatively spacious house near Jama Masjid in August 1934. In September 1935, the clinic was again moved to a well-ventilated and spacious building named “Hanging Bridge” near Edward Park in Daryaganj. This was the first TB Clinic in Delhi, and it demonstrated the efficacy of managing TB patients on out-patient basis in an era when no specific anti-TB drugs were available. The statistics for the period 1933-35 demonstrated the need and advantages of such care for poor TB patients who could not afford to be admitted to TB Sanatoria.

Ramakrishna Mission T.B. Clinic

Ramakrishna Mission T.B. Clinic

A scheme for a permanent building was formulated in 1938. The Mission authorities had approached the local government for the allotment of a plot of land in Daryaganj for erecting a permanent building for the clinic. While the local government agreed to allot a site and negotiations for it were proceeding, Delhi Improvement Trust came into existence and offered an alternative site near Kashmiri Gate, which the Mission authorities accepted. Later, with the modification of the TB Control Programmes in 1938, Delhi Improvement Trust offered the Mission authorities the present site at Karol Bagh (Arya Samaj Road) in 1940. The Mission got possession of the land on 11 March 1940. An additional plot of land was also acquired for staff quarters etc. Construction of the TB Clinic building was completed by the end of 1947. The formal opening ceremony of the new building was performed by Union Health Minister Rajkumari Amrit Kaur. In August 1949, the clinic began to admit indoor patients to its 16 observation beds. An ENT department was added the same year. Another building to accommodate residential staff was constructed on an adjacent plot of land in 1954.

When the government decided to involve NGOs under the Revised National Tuberculosis Control Programme (RNTCP), the Ramakrishna Mission Free TB Clinic was selected as the district centre for Karol Bagh. The clinic had adopted Directly Observed Therapy Short Course (DOTS) in 1996, though the RNTCP was officially launched on 28 October 1998.

The RNTCP at Ramakrishna Mission Free TB Clinic comprises the following components:

  1. Case finding: diagnosis of new TB patients.
    1. Treatment of TB patients, both DOTS and non DOTS.
    2. Symptomatic support to cases of TB and other diseases.
  2. Diagnosis of multidrug resistant (MDR) and extensive drug resistant (XDR) cases of TB by sending suspects for sputum culture and drug sensitivity (culture and DST)
  3. Treatment of MDR and XDR cases.
  4. Case holding: Motivation of all TB cases for continuation of treatment for 6-8 months and MDR/XDR cases for 2 years.
  5. Selection of serious patients for admission to TB hospitals.
  6. Examination of contacts of sputum positive patients for presence of disease.
  7. Providing INH chemoprophylaxis to children below 6 years of sputum positive patients.
  8. Screening of all TB patients for HIV and referring HIV positive patients for antiretroviral therapy (ART).
  9. Giving health education to patients, their families, and to the community at large.
  10. Conducting awareness programmes for tuberculosis in schools.
  11. Arranging painting competitions on tuberculosis for school children.
  12. Conducting sensitization programmes for medical officers of government dispensaries.
  13. Involving private practitioners in the RNTCP programme.

The staff of this clinic consists of a District Tuberculosis Officer, medical officers, a senior treatment supervisor (STS), a senior tuberculosis laboratory supervisor (STLS), a senior DOTS Plus-HIV Supervisor, DOT providers, laboratory technicians, an X-ray technician, clerks and assistants. At present two health visitors are provided by Municipal Corporation of Delhi (MCD).

The clinic has the following facilities for diagnosis and treatment of tuberculosis:

  • A clinical laboratory for sputum examination by smear microscopy.
  • A 200 mA X-ray unit installed in 1972-3 with the help of grant-in-aid received from the Ministry of Health, Government of India.
  • An Odelca 100 mm camera for mass miniature radiography.
  • Free supply of antitubercular drugs for all categories of tuberculosis patients is made available through RNTCP. Free medicines for associated illnesses in tuberculosis patients are also provided at the clinic.

As of 31 March 2015, 3 Designated Microscopy Centres (DMCs) and 6 DOT centres were running successfully under the Free TB Clinic. The 3 DMC cum DOTS centres were located at Ramakrishna Mission Free TB Clinic and in Delhi government dispensaries at Tank Road and Anand Parbat. The remaining 3 DOTS centres were located in CGHS dispensaries at Pusa Road, New Rajinder Nagar  and Dev Nagar.

Health Education and Public Awareness

Besides giving treatment to TB patients and chest symptomatics, this clinic also imparts health education to patients and to the community at large. In each DOT Centre an interactive meeting between DOT providers and patients is held every month where complete information to patients about Tuberculosis is given and their queries about treatment answered.

A Health Awareness Programme (HAP) on ‘Stop Tuberculosis, Tobacco Use Prevention and Health & Nutrition’ was conducted in 21 schools between July and September 2014. As part of this initiative Health Awareness sessions on ‘Stop TB’, involving multimedia presentations and interactive participation of students and teachers, were carried out where 743 students as well as a select group of teachers were sensitized. 370 of these students (271 boys & 99 girls) participated in programme evaluation. In the HAP sessions on ‘Tobacco Use Prevention’, involving multimedia presentations and interactive participation of students and teachers, and pre and post-programme evaluation, 473 students as well as a select group of teachers were sensitized. 425 of these students (354 boys & 71 girls) participated in programme evaluation. The Health and Nutrition sessions, involving multimedia presentations, storyboards and games as well as student evaluation, sensitized 4077 students and a select group of teachers. 3168 of these students (1211 boys & 1957 girls) participated in programme evaluation.

Public Meetings, Community Meetings and other Programs

This centre conducts public and community meetings every year to bring awareness about Tuberculosis, its treatment, its social and economic impact on the family, society, and nation at large to the public, TB patients, and leaders of the community.

The clinic held its Annual Public Meeting and Blanket Distribution Programme on 8.12.2014. Dr. Ashwani Khanna, State Programme Officer, RNTCP, New Delhi, Dr. Subhash Seth, CDMO and MD, IDHS, Central and Dr. S.M. Govil, Honarary General Secretary, Delhi TB Association, were the Guests of Honour on this occasion. Over 250 TB patients, besides members of the public, participated in the programme. The highlight of the occasion was the personal accounts of TB patients sharing their brave struggle to cope with serious disease. Blankets, including 100 donated by Delhi TB Association, were distributed to all participating TB patients.

A community meeting was held on 23.02.2015 at the clinic premises to sensitize MDR TB patients and the community regarding the medical and socioeconomic needs of MDR patients and the treatment and support they are provided at the clinic. 4 community meetings in and around local govt. dispensaries and N C Joshi hospital, 4 road side magic shows, film shows at a zonal science exhibition for primary school children, a painting competition for children on anti TB treatment, and a sensitization programme for community DOT Providers and ASHA workers were held as part of World TB Day celebrations to generate public awareness on the need to reach out to over 3 million un-reached TB patients across the globe.

MDR TB Patient Support

As many TB patients are poor and cannot afford a nutritious diet the centre provides them with milk, eggs, biscuits, food grain and other food supplements. Select patients are also provided pecuniary aid for purchase of food supplements and for education of their children. During winters a large number of patients are supplied blankets.

As of 31 March 2015, 53 patients were on treatment for MDR TB and 7 for XDR TB at the clinic. These patients have advanced disease that requires prolonged and complicated therapy. Many of them are from underprivileged socioeconomic background and their disease often leaves them incapable of work for prolonged periods. The clinic has started an economic aid scheme for these patients since December 2011. 118 patients received financial support for varying durations between January and December 2014. 79 of these patients were on treatment for DR TB. The other 39 were poor and needy TB patients on Directly Observed Therapy Short Course (DOTS) or non-DOTS regime. All supported patients also received 1 kg pulses every month as additional nutritional support. The majority were further provided 5 kg rice and a select group was given cooking oil, ghee, and jaggery as nutritional supplement. MDR TB patients are given financial aid for travel to DOT centres for injections and for nutritional support. Further, MDR TB patients need to take medicines with significant toxicities which call for close laboratory monitoring of these patients. The cost of these investigations is also being supported by the clinic.

Last updated: October 9, 2015 at 19:50 pm